Williams Jason, Herman-Stahl Mindy, Calvin Sara L, Pemberton Michael, Bradshaw Michael
Behavioral Health and Criminal Justice Research Division, RTI International, Hobbs bldg, 3040 Cornwallis Rd, RTP, NC 27709, USA.
Drug Alcohol Depend. 2009 Mar 1;100(3):248-57. doi: 10.1016/j.drugalcdep.2008.10.007. Epub 2008 Dec 9.
This study explored the mediating mechanisms of two Web-based alcohol interventions in a sample of active duty United States military personnel. Personnel were recruited from eight bases and received the Drinker's Check-Up (N=1483), Alcohol Savvy (N=688), or served as controls (N=919). The interventions drew on motivational interviewing and social learning theory and targeted multiple mediators including social norms, perceived risks and benefits, readiness to change, and coping strategies. Baseline data were collected prior to the intervention and follow-up data on alcohol consumption were gathered 1 month and 6 months after program completion. Two mediation models were examined: (1) a longitudinal two-wave model with outcomes and mediators assessed concurrently at the 1-month follow-up; and (2) a three-wave model in which the causal chain was fully lagged. Results indicated strong support for the role of perceived descriptive norms in transmitting the effects of the Drinker's Check-Up, with consistent mediation across the majority of alcohol outcome measures for both the concurrent and fully lagged mediation models. These results suggest that web-based interventions that are effective in lowering perceived norms about the frequency and quantity of drinking may be a viable strategy for reducing alcohol consumption in military populations. The results did not support program mediation by the other targeted variables, indicating the need for future research on the effective components of alcohol interventions. The mediation models also suggest reasons why program effects were not found for some outcomes or were different across programs.
本研究探讨了两种基于网络的酒精干预措施在美国现役军人样本中的中介机制。研究人员从八个基地招募了人员，他们分别接受了饮酒者检查（N = 1483）、酒精知识普及（N = 688），或作为对照组（N = 919）。这些干预措施借鉴了动机性访谈和社会学习理论，针对多个中介变量，包括社会规范、感知到的风险和益处、改变的意愿以及应对策略。在干预前收集了基线数据，并在项目完成后的1个月和6个月收集了酒精消费的随访数据。研究考察了两种中介模型：（1）一种纵向两波模型，在1个月随访时同时评估结果和中介变量；（2）一种三波模型，其中因果链完全滞后。结果表明，感知到的描述性规范在传递饮酒者检查的效果方面发挥了重要作用，在同时性和完全滞后性中介模型的大多数酒精结果测量中都存在一致的中介效应。这些结果表明，基于网络的干预措施如果能有效降低对饮酒频率和量的感知规范，可能是减少军人酒精消费的一种可行策略。结果不支持其他目标变量的项目中介作用，这表明未来需要对酒精干预措施的有效成分进行研究。中介模型还揭示了某些结果未发现项目效果或不同项目效果存在差异的原因。
